Ureases (3.5.1.5), enzimas níquel dependentes que catalisam a reação de hidrólise da uréia em amônia e dióxido de carbono, apresentam ampla distribuição em plantas, fungos e bactérias. A espiroqueta Helicobacter pylori causa úlceras pépticas e câncer gástrico por mecanismos ainda não totalmente conhecidos. H. pylori produz grande quantidade de urease, que neutraliza o meio ácido e permite sua sobrevivência no estômago. Nosso grupo demonstrou que as ureases de Canavalia ensiformis, soja e Bacillus pasteurii induzem agregação plaquetária independentemente de sua atividade ureolítica, por uma rota que requer ativação de canais de cálcio. ativação da rota do ácido araquidônico e secreção plaquetária. Estudos prévios mostraram ainda que a canatoxina, uma isoforma da urease de C.ensiformis, possui atividade pró-inflamatória, induzindo edema de pata em ratos. Neste trabalho, caracterizamos as propriedades ativadora de plaquetas e pró-inflamatória da urease recombinante de H. pylori (HPU). Em plaquetas, estudamos as vias recrutadas pela proteína na agregação plaquetária e comparamos com dados prévios para a canatoxina e a urease de Bacillus pasteurii. Em neutrófilos, demonstramos que a HPU, em doses nanomolares, induz quimiotaxia e produção de espécie reativas de oxigênio. A taxa de apoptose de neutrófilos ativados por HPU foi inibida, acompanhando alterações dos níveis de proteínas pró- e antiapoptóticas. Por último, mostramos que a resposta dos neutrófilos a HPU envolve aumento dos níveis de lipoxigenase(s), sem, contudo, haver alterações das ciclooxigenase( s). Concluímos que as propriedades não enzimáticas aqui descritas para a HPU podem potencialmente contribuir para o processo inflamatório promovido por H. pylori. / Ureases (EC 3.5.1.5), nickel-dependent enzymes that hydrolyze urea into ammonia and carbon dioxide, are widespread among plants, bacteria and fungi. The spirochete Helicobacter pylori is the etiological agent of gastric ulcers and gastric adenocarcinoma by mechanisms not yet fully understood. H. pylori produces high amounts of urease, which enables the bacterium to survive in the acidic medium of the stomach. We have previously reported that ureases from jackbean, soybean or Bacillus pasteurii induce blood platelet aggregation independently of their enzyme activity by a pathway requiring activation of calcium channels, lipoxigenase-derived eicosanoids and platelet secretion. We also showed that canatoxin, an isoform of C. ensiformis urease, presents pro-inflammatory property demonstrated by rat paw oedema. In this work we characterized the platelet aggregating and pro-inflammatory properties of the recombinant H. pylori urease (HPU). In platelets we studied the pathways recruited by the protein to induce platelet aggregation and compared the data to those previously reported for the plant urease canatoxin and for Bacillus pasteurii urease. Using neutrophils we demonstrated that nanomolar doses of HPU induce chemotaxis and production of oxygen reactive species in human neutrophils. The rate of apoptosis was decreased in HPU-treated neutrophils, accompanied by alterations in the levels of proand anti-apoptotic proteins. Moreover, we showed that the response of neutrophils to HPU requires increased levels of lipoxygenase(s) with no alterations of cyclooxygenase( s). We concluded that the non-enzymatic properties of HPU here described potentially contribute to the inflammatory process that underlies H. pylori infection.

Orientador: Jose Pedrazzoli Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T15:29:11Z (GMT). No. of bitstreams: 1 Becker_TaglianeLiza_M.pdf: 5325289 bytes, checksum: d08598655314f45f1785148d9eb3b6b0 (MD5) Previous issue date: 2005 / Resumo: As principais causas de ulceração da mucosa gástrica são o uso prolongado de antiinflamatórios não-esteroidais (AINEs) e a infecção pelo Helicobacter pylori. Pacientes com ulcerações gástrica são tratados, principalmente, com antagonistas de receptor de histamina-2 e inibidores de bomba protônica, que neutralizam elou reduzem a secreção ácida. Estudos têm mostrado que estas drogas possuem propriedades adicionais de inibirem funções leucocitárias. Estas propriedades são de relevante importância, visto que a lesão na mucosa gástrica induzida tanto por AINEs quanto pelo H. pylori, envolve diretamente a participação de neutrófilos. Baseado nestes relatos, os objetivos deste trabalho foram: 1) padronizar o modelo de inflamação induzida por H. pylori em bolsa de ar na pele dorsal de ratos; 2) avaliar a possível atividade antiinflamatória de inibidores de secreção ácida modelo experimental. A inoculação de H. pylori na bolsa de ar em ratos causou um significativo infiltrado neutrofílico, sendo este, dependente da concentração e, independente da viabilidade e do genótipo das linhagens inoculadas. Nota-se que após o tratamento com os inibidores de secreção ácida, durante 7 ou 28 dias, a produção de exsudato inflamatório e migração de leucócitos na bolsa de ar incubada com H. pylori ou carragenina não foi alterada. Em contraste, a dexametasona, antiinflamatório esteroidal, inibe significantemente a resposta inflamatória. Ao contrário dos estudos anteriores, esses resultados indicam que os inibidores de bomba protônica e os antagonistas de receptor H2 não possuem atividade antiinflamatória no modelo de inflamação in vivo induzido pelo H. pylori em bolsa de ar em ratos, quando utilizados por curto ou longo período / Abstract: Helicobacter pylori infection and the administration of nonsteroidal antiinflammatory drugs are the main causes of gastric ulcerations. In the clinical setting, patients with gastric ulcerations are treated with histamine-2 (H2) receptor antagonists and proton pump inhibitors (PPI) to neutralize or reduce the acid secretion. Recently, studies have shown that these drugs have additional properties related to their capacity to inhibit some neutrophil functions. Since the damage to gastric mucosa, associated with H. pylori or nonsteroidal anti-inflammatory drugs, is also induced by neutrophils these properties could be beneficial. In the present study, we characterized the inflammatory response induced by H. pylori in the rat air pouch model. We also evaluated the anti-inflammatory activity of acid secretion inhibitors such as omeprazole, lanzoprazole, pantoprazole and cimetidine in this experimental model. The injection of H. pylori into rat air pouch caused pronounced neutrophil infiltration. This response was dependent upon the number of bacteria injected and independent of bacterial viability and genotype. The duration of treatment with the acid secretion inhibitors did not affect the ability of neutrophils to migrate in response to H. py/ori or carrageenan. On the other hand, dexamethasone, a classic anti-inflammatory drug, reduced the exudate formation and leukocyte migration. Our results indicate that proton pump inhibitors or histamine-2 receptor antagonists have no anti-inflammatory activity in vivo / Mestrado / Mestre em Farmacologia

Doctor en Farmacología / Helicobacter pylori (H. pylori) infecta la mucosa gástrica de la mitad de la población mundial, y es el único microorganismo conocido capaz de sobrevivir exitosamente en el estómago humano. Muchos estudios han establecido a H. pylori como agente etiológico del cáncer gástrico, linfoma del tejido linfoide asociado a la mucosa (MALT), y la úlcera péptica. En efecto, en 1994, la Agencia Internacional para la Investigación sobre el Cáncer (IARC) de la Organización Mundial de la Salud (OMS), definió a H. pylori como un agente carcinógeno definitivo (tipo I) en el cáncer gástrico. Es importante destacar que en Chile la prevalencia de la infección por H. pylori normalizada para la población mundial de entre 20 y 60 años es aproximadamente de un 80%. Este alto nivel de infección por H. pylori explicaría por qué Chile tiene la mayor tasa de mortalidad por cáncer gástrico en América, y se ubica entre los cinco primeros países del mundo con respecto a la mortalidad por cáncer gástrico. Sin embargo, la gran mayoría de las personas infectadas con H. pylori permanece asintomática. El tratamiento de la infección por H. pylori requiere el uso de una combinación de antibióticos con un inhibidor de la bomba de protones. La literatura muestra un aumento en la aparición de cepas resistentes a los antibióticos, por lo que hoy en día es importante buscar sustancias no-antibióticas con actividad anti-H. pylori. Entre éstas, un número importante de diferentes productos del reino vegetal han sido probados, incluyendo antimicrobianos pertenecientes a diferentes grupos de fitoquímicos, tales como los aceites esenciales y los polifenoles. Los polifenoles son componentes ubicuos de plantas medicinales y nutricionales. Estos compuestos, no sólo actuarían como antioxidantes, sino que también podrían ejercer actividades antimicrobianas en diferentes porciones del tracto digestivo. Numerosos antecedentes sugieren que el consumo regular de alimentos o bebidas ricas en polifenoles, podría ayudar a prevenir y atenuar el daño a la mucosa gástrica inducido por H. pylori. En relación con esto último, las manzanas poseen muchas propiedades beneficiosas para la salud humana asociadas con su alto contenido en compuestos fenólicos. Entre las diversas variedades, las manzanas Granny Smith se exportan tanto como producto fresco como para la producción de jugo concentrado. Aunque una gran parte de estas exportaciones considera el uso de la fruta entera, en la última década, los productos de manzana deshidratada han tenido un aumento significativo. Puesto que la deshidratación requiere la eliminación de la cáscara, se llega a acumular importantes cantidades de ésta, las que constituyen un residuo agroindustrial que genera problemas a las empresas con las autoridades de la CONAMA. Algunas variedades de manzana podrían tener entre un 40 a 50% de los polifenoles totales del fruto en la cáscara. De hecho, la concentración de polifenoles en la cáscara puede triplicar al observado en la pulpa. Los principales grupos de polifenoles de la manzana incluyen los glucósidos de flavonoides, ésteres fenólicos de ácidos carboxílicos, dihidrochalconas, catequinas y procianidinas. Los polifenoles de la cáscara de manzana podrían actuar contra H. pylori no sólo como agentes antimicrobianos, sino también neutralizando algunos de sus factores de virulencia. También estos compuestos podrían reducir el daño inducido por las especies reactivas del oxígeno y nitrógeno (ERON) generadas durante el proceso inflamatorio asociado a la infección. En esta tesis se realizó un estudio farmacológico de los efectos in vitro e in vivo de un extracto enriquecido en polifenoles de cáscara de manzana sobre H. pylori. La preparación del extracto de cáscara de manzana (APPE) se llevó a cabo utilizando adsorción de los polifenoles en la resina Sepabeads SP-850. De esta forma, los polifenoles de los extractos acuosos de cáscara de manzana fueron adsorbidos en forma exitosa. Los polifenoles fueron recuperados con etanol y concentrados en rotavapor, llegando a un rendimiento de 3.50 ± 0.7 g por 1000 g de cáscara de manzana fresca. El contenido de polifenoles totales fue de ~ 60%, con un perfil HPLC-DAD casi idéntico al obtenido en la cáscara fresca de manzana Granny Smith. El análisis específico de los compuestos polifenólicos de APPE obtenidos por RP-HPLC, permitieron identificar la presencia de: (1) ácido clorogénico, (2) procianidina B1, (3) procianidina B2, (4) (-)-epicatequina, (5) procianidina C1, ( 6) rutina, (7) hiperósido, (8) isoquercitrina (9), quercetina-3-O-pentósido, (10), quercetina-3-O-pentósido, (11) quercitrina, (12) floretina-O-xiloglucósido, y (13) floridzina. Para confirmar la identidad de los 13 principales componentes se desarrolló un método de separación por HPLC-ESI/MS/MS, el cual permitió obtener la huella digital de APPE caracterizada por el perfil de polifenoles. Usando RP-HPLC, se logró una muy buena separación de los glucósidos quercetina y algunas procianidinas desde los monómeros hasta los trímeros. Mediante RP-HPLC no fue posible separar los oligómeros superiores a los trímeros, probablemente debido al gran número de isómeros que interfieren con la separación. Por lo tanto, para el análisis de oligómeros de prociandinas superiores de los trímeros se consideró a la NP-HPLC como la técnica más adecuada. Así, con el uso de la NP-HPLC, las procianidinas desde los monómeros a los undecámeros fueron separadas según su grado de polimerización, siendo éste el método de elección para la separación de oligómeros. Con el objetivo de fraccionar los polifenoles de APPE de acuerdo a su tamaño molecular, se utilizó una combinación de cromatografía en columnas de Sephadex LH-20 y Toyopearl HW-40. Como resultado de esta estrategia, se obtuvieron las fracciones de polifenoles de bajo peso molecular (LMW) y alto peso molecular (HMW). La determinación del grado de polimerización (mDP) de APPE, HMW y LMW se llevó a cabo mediante depolimerización por floroglucinólisis y tiólisis con cisteamina y tolueno--tiol. La depolimerización generada por dichos nucleófilos permitió obtener perfiles donde claramente se identificó como principal unidad de extensión y de término a la epicatequina. Por medio del estudio de los productos de despolimerización y los perfiles de NP-HPLC, fue posible confirmar que en su mayoría LMW posee unidades monoméricas (mDP = 1). APPE posee un mDP = 2-4, mientras que para HMW mDP = 8-10. Se evaluó el efecto del extracto APPE y las fracciones LMW y HMW sobre la viabilidad de H. pylori, la actividad de la ureasa y el estallido respiratorio de neutrófilos. Los resultados sugieren, en base a los valores de sus IC50, que la actividad inhibitoria de la ureasa mostrada por APPE estuvo asociada principalmente a la presencia de polifenoles de alto peso molecular (HMW) y, en menor grado, con de la presencia de los componentes de bajo peso molecular (LMW). Tal inhibición fue concentración-dependiente, tiempo-independiente, reversible y competitiva. Por el contrario, el efecto de APPE tanto sobre la viabilidad de H. pylori, como sobre la producción de las especies reactivas del oxígeno (ERO) por parte de los neutrófilos, se asoció principalmente con los componentes de LMW. APPE pudo inhibir el estallido respiratorio de neutrófilos inducido por H. pylori, PMA y fMLP en forma concentración-dependiente. Este efecto se observó tanto en el interior como en el exterior de los neutrófilos. Este resultado indicó que APPE podría atenuar el daño a la mucosa gástrica asociado a las ERO producidas por los neutrófilos, particularmente cuando H. pylori despliega sus mecanismos de evasión. Se investigaron los efectos inhibitorios de APPE contra la infección por H. pylori, y la vacuolación inducida por VacA. APPE disminuyó significativamente la vacuolación en células HeLa con un valor de IC50 de 450 g GAE / mL. APPE también mostró un efecto anti-adherente in vitro contra H. pylori. Se observó una inhibición significativa de la adhesión de H. pylori con una reducción del 20-60% para concentraciones de entre 0.250 y 5 mg GAE / mL. En un modelo a corto plazo de infección (ratones C57BL6 / J), dos niveles de dosis de APPE (150 y 300 mg / kg / día) mostraron un efecto inhibitorio sobre el asentamiento de H. pylori. Después de 7 días de cultivo, no fue posible recuperar bacterias con la morfología típica de H. pylori, tanto en los grupos tratados con APPE como en los controles no infectados. Paralelamente, el análisis por PCR de tiempo real de los estómagos de animales tratados con APPE, no mostró diferencias significativas con el control no infectado. Estos resultados concordaron con la visible reducción de la carga de H. pylori observada en las evaluaciones histológicas. Pese al corto plazo de interacción huésped-patógeno y el bajo índice de gastritis observado en los animales infectados, los polifenoles de APPE mostraron un efecto anti-inflamatorio sobre la gastritis asociada a la presencia de H. pylori, reduciendo los niveles de malondialdehído. En esta tesis se ha demostrado que APPE podría ejercer sus efectos anti-H. pylori mediante múltiples mecanismos. Así, los polifenoles de alto peso molecular inhibieron la actividad de la ureasa, el proceso de adhesión de las bacterias a la mucosa gástrica y la actividad de la toxina VacA. Por otro lado, las propiedades anti-H. pylori y atrapadoras de ERO fueron ligadas a la presencia de los polifenoles de bajo peso molecular. Como era de esperar, el efecto antioxidante de APPE y sus propiedades anti-VacA, probablemente cumplan un papel en la disminución del daño inflamatorio in vivo causados por H. pylori a la mucosa gástrica de los ratones infectados. En resumen, en este estudio se observó que APPE puede prevenir eficazmente las primeras etapas del proceso de colonización gástrica por H. pylori y suprimir algunas de sus consecuencias patológicas más relevantes como la inflamación / Helicobacter pylori (H. pylori) infects the gastric mucosa of half of the world´s population, and is the only microorganism known to successfully inhabit the human stomach. Many studies have established H. pylori as an etiologic agent of gastric cancer, mucosa-associated lymphoid tissue lymphoma (MALT), and peptic ulcer. In fact, in 1994, the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) defined H. pylori as a definite carcinogen in gastric cancer (type I). Importantly, in Chile the prevalence of H. pylori infection standardised for world population for ages 20 to 60 is approximately 80%. This high level of H. pylori infection may explain why Chile has the highest rate of gastric cancer mortality in the Americas, and is among the top five countries in the world with regard to gastric cancer mortality. However, the vast majority of people infected with H. pylori has no symptoms and will never develop problems. The treatment of H. pylori infection requires the use of two or more antibiotics combined with a proton pump inhibitor. The occurrence of strains resistant to antibiotics has been to increasing, and it is nowadays important to search for new alternatives to antibiotics with anti-H. pylori activity. Among these, a number of different products from vegetable origin have been tested, including antimicrobials belonging to phytochemical such as essential oils and polyphenols. Polyphenols are ubiquitous constituents of medicinal and nutritional plants. Such compounds, not only would act as antioxidants, but also they could exert antimicrobial activities in different portions of the digestive tract. Growing evidence suggests that regular intake of foods or polyphenol-rich beverages might help to prevent and attenuate H. pylori-induced damage to the gastric mucosa. Regarding the latter, apples possess many beneficial properties for the human health related to their high content in phenolic compounds. Among several varieties, Granny Smith apples are exported both as fresh product and as juice concentrates. Although a great part of such exports considers the whole fruit, during the past decade, exports of value added dehydrated apple products have had a significant increase. Since dehydration requires peel removal, important amounts of apple peel accumulate to be largely classified as an agro-industrial waste. Some apple varieties concentrate in the peel from 40 to 50% of the total fruit polyphenols. In fact, the amount of polyphenols in the apple peel could be up to three times higher than that found in the pulp. The principal classes of whole apple polyphenols include flavonoid glycosides, phenol carboxylic acid esters, dihydrochalcones, catechins, and procyanidins. Apple peel polyphenols might act against H. pylori exerting not only an antimicrobial action but also neutralizing some of its virulence factors. These compounds could also reduce the damage induced by the Reactive Oxygen and Nitrogen Species (RONS) generated during the inflammatory process associated to the infection. In this thesis a pharmacological study was undertaken considering the in vitro and in vivo effects of an apple peel polyphenols-enriched extract upon H. pylori. The preparation of apple peel extract (APPE) was carried out using the adsorption resin Sepabeads SP-850. Thus, the polyphenols from the aqueous extracts of apple peel were successfully adsorbed. Recovery of the polyphenols was carried out with ethanol and concentrated through evaporative rotation with a yield of 3.50± 0.7g from 1000 g of fresh apple peel. Total polyphenolic content was ~60 % with a HPLC-DAD profile remarkably similar to that obtained in the fresh peel of Granny Smith apples. Specific analysis of APPE polyphenolic compounds by RP-HPLC allowed to identify the presence of (1) chlorogenic acid, (2) procyanidin B1, (3) procyanidin B2, (4) (−)-epicatechin, (5) procyanidin C1, (6) rutin, (7) hyperoside, (8) isoquercitrin, (9) quercetin-3-O-pentoside, (10) quercetin-3-O-pentoside, (11) quercitrin, (12) phloretin-O-xyloglucoside, and (13) phloridzin. To confirm the identity of the 13 main components of APPE a fingerprint profile method was developed using HPLC-ESI/MS/MS method. Using RP-HPLC, the extremely good separation of quercetin glycosides and individual procyanidins from monomers to trimers was achieved. RP-HPLC method was not able to separate oligomers higher than trimers probably due to the higher number of isomers interfering with the separation. Hence, NP-HPLC was better suited for analysis of procyandin oligomers higher than trimers. Using NP-HPLC, procyanidin monomers through undecamers were separated by the degree of polymerization and the separation of higher oligomers was preferable. With the aim to fractionate APPE polyphenols according to their molecular size, a combination of Sephadex LH-20 and Toyopearl HW-40s column chromatography was used. As result of this strategy, low molecular weight (LMW) and high molecular weight (HMW) polyphenolic fractions were obtained. Determination of mDP of APPE, HMW and LMW was carried out by depolymerization via phloroglucinolysis and thiolysis with cysteamine and toluene--thiol. Depolymerization with nucleophile generated profiles where it is clearly seen that the main extension and terminal unit was epicatechin. By means of the study of depolymerization products and NP-HPLC profiles, it was possible to confirm that LMW possesses mostly monomeric units (mDP = 1). APPE possesses an mDP = 2-4, while for HMW mP = 8-10. The effect of APPE, LMW y HMW against H. pylori viability, urease activity and neutrophil respiratory burst was evaluated. On the basis of the IC50 ranking order, the results suggested that the urease-inhibitory activity displayed by APPE is associated, primarily, with the presence of HMW polyphenols and, to a lower degree, with the presence of monomeric components (LMW). Such urease inhibition was concentration-dependent, time-independent, reversible and competitive. On the contrary, inhibitory effect for both viability and reactive oxygen species (ROS) production by stimulated neutrophils was associated mainly with LMW components. Thus, APPE inhibited the respiratory burst of neutrophils induced by H. pylori, PMA and fMLP in concentration-dependent form. This effect was observed on both the interior and exterior of the neutrophil. This result suggests that APPE have an attenuating effect on the damage to gastric mucosa caused by neutrophil generated ROS and, particularly, when H. pylori display its evasion mechanism. The inhibitory effects of APPE against H. pylori infection, and VacA-induced vacuolation were investigated. APPE significantly prevented vacuolation in HeLa cell with an IC50 value of 450 g GAE/mL. APPE also displayed an in vitro anti-adhesive effect against H. pylori. A significant inhibition was observed with a 20-60% reduction of H. pylori attachment at concentrations between 0.250 and 5 mg GAE/mL. In a short-term infection model (C57BL6/J mice), two levels of APPE doses (150 and 300 mg/kg/day) showed an inhibitory effect on H. pylori attachment. After 7 days of culture, it was not possible to recover bacteria with the typical H. pylori morphology neither in the groups treated with APPE nor in the controls. Real-time PCR analysis of the stomachs from animals treated with APPE did not show significant differences with non-infected control mice. These results were in agreement with the visible reduction in H. pylori load observed in the histology evaluations. Although the short-term pathogen-host interaction period and the low gastritis score observed in the infected animals, APPE showed an anti-inflammatory effect on the H. pylori-associated gastritis lowering malondialdehyde levels. In this thesis it has been demonstrated that APPE could exert their anti-H. pylori effects by multiple mechanism. So, high molecular weight polyphenols inhibit the urease activity, the process of adherence of the bacteria to the gastric mucosa and the activity of VacA toxin. On another side, low molecular weight polyphenols were involved in the anti-H. pylori and ROS scavenging properties of APPE. As expected, the antioxidant and anti-VacA properties of APPE probably played a role in diminishing the in vivo inflammatory damage caused by H. pylori to the mice gastric mucosa. In summary, in this study it was observed that APPE can effectively prevent the initial steps in the H. pylori colonization process and suppress some of their most relevant pathological consequences such as mucosal inflammation

A bactéria Gram negativa Helicobacter pylori, além de estar associada ao câncer gástrico e duodenal, está relacionada a patologias extra gástricas. Entre essas estão as doenças cardiovasculares. Os mecanismos pelos quais o H. pylori pode causar, ou agravar essas doenças, ainda não são claros. A urease de H. pylori (HPU) é considerada um fator de virulência, visto que sua atividade catalítica cria um microambiente de pH mais elevado, possibilitando a sobrevivência do patógeno no estômago. A HPU é capaz de ativar plaquetas de coelho através da indução da secreção de seus grânulos densos com liberação de ADP, culminando na agregação plaquetária. Esse fenômeno ocorre via 12- lipoxigenase, rota de sinalização também utilizada pelo colágeno, um importante agonista intrínseco desse sistema. Demonstramos previamente que também as duas subunidades da HPU, HpUreB e HpUreA, interagem com membranas de plaquetas de coelho, sendo que a HpUreB contém o domínio da holoenzima responsável pela agregação plaquetária. Essa interação entre HPU e plaquetas pode ser mediada por GPVI, o principal receptor de colágeno dessas células No presente trabalho, estudamos a interação da HPU e suas subunidades com plaquetas humanas, através de citometria de fluxo. Demostramos que HPU ativa plaquetas humanas sem exposição significativa de P-selectina. O bloqueio com anticorpos específicos para o receptor de membrana GPIIbIIIa, mas não para GPVI, interfere na ativação plaquetária induzida por HPU. Em plaquetas ativadas por HPU ocorrem modificações do processamento pré-mRNA de proteínas pró-inflamatórias, aumentando os níveis de mRNAs que codificam IL-1 e CD14, indicando que plaquetas passam a apresentar um fenótipo pró-inflamatório após exposição à urease. No conjunto, nossos dados sugerem que a HPU, além de permitir a sobrevivência bacteriana na mucosa gástrica, pode ter um papel importante, e até agora negligenciado, nos estados inflamatórios associados com a infecção por H. pylori. / The Gram negative bacterium Helicobacter pylori, besides its association with gastric and duodenal cancer, correlates positively to several extragastric diseases suchas cardiovascular pathologies. However, the mechanisms by which H. pylori can cause or aggravate these diseases are still unclear. H. pylori urease (HPU) is considered a virulence factor, since its catalytic activity creates a microenvironment, of higher pH, that allows survival of the pathogen in the stomach. HPU is able to activate rabbit platelets by inducing the secretion of their dense granules with release of ADP, culminating in platelet aggregation. This phenomenon occurs with activation of the 12-lipoxygenase pathway, which is also used by collagen, an important intrinsic agonist of this system. We have previously demonstrated that both subunits of HPU, HpUreB and HpUreA, interact with rabbit platelet membranes, and that HpUreB contains the domain responsible for platelet aggregation This interaction of HPU and platelets could be mediated by GPVI, the main collagen receptor in these cells. In this work, by using flow cytometry assay, we have studied the interaction of HPU and of its subunits with human platelets. HPU was shown to activate human platelets without significant P-selectin exposure. Blockage with antibodies against the membrane receptor GPIIbIIIa, but not against GPVI, interfered on platelet activation induced by HPU. The processing of pre-mRNA of proinflammatory proteins was evaluated in HPU-activated platelets and increased levels of mRNAs encoding IL-1 and CD14 were found, indicating that platelets acquire a proinflammatory phenotype when exposed to the urease. Altogether, our data suggest that H. pylori urease, besides allowing bacterial survival within the gastric mucosa, may have an important, and so far overlooked role in the inflammation associated to the infection by H. pylori.

Objetivo: Evaluar la asociación entre la presencia de H. pylori y sangrado en los primeros 30 días post operatorios de gastrectomía en manga. Diseño: Cohorte retrospectiva basada en un análisis de datos secundarios.

BACKGROUND: For the last 15 years, infection from Helicobacter pylori (H. pylori) has been recognized in gastritis pathogenesis, and is known to trigger an important inflammatory response in these patients. AIM: To determine the association between follicular gastritis and the infection of H. pylori in children seen at a public hospital in Peru. METHODOLOGY: An analytic, cross-sectional study was conducted on all the children treated at the Hospital Nacional Docente Madre "Niño San Bartolomé" in Lima, Peru, within the time frame of 2011-2012. All the personal data from the patients' medical histories and endoscopic procedures were collected. The crude prevalence ratios (PR) were obtained and adjusted (aPR) with their 95% confidence intervals (95%CI), using generalized linear models with the binomial family and log link function. RESULTS: A total of 123 children met the study criteria. Forty-eight (39%) of the study sample were girls and the mean age of the children was 12 years. H. pylori was present in 44% of the sample and 9% presented with more than 100 bacteria per field (classified as +++). Thirty-five percent of the children had esophagitis due to concomitant reflux. The presence of H. pylori was associated with follicular gastritis (P<.01; PRa: 2.3; 95% CI:1.49-3.49), adjusted by the children's age. CONCLUSIONS: Based on the data analyzed, it was concluded that the children with follicular gastritis had a greater likelihood of having H. pylori than those that did not present with gastritis. These results can be extrapolated to other similar populations and should be evaluated in each setting so that this does not become a public health problem within the next few years. / Peer review

Helicobacter pylori (HP), known to cause active chronic gastritis, has primarily been found in gastric-type mucosa. Even in the duodenum, the organism was detected in islands of metaplastic gastric mucosa. HP has also been found in gastric metaplasia of Barrett's esophagus in 15-50%. The aim of our study was to determine: (1) the frequency with which HP is found on histopathological sections of heterotopic gastric mucosa (HGM) patch(es) at the upper esophagus, as compared to that of the stomach proper, and (2) the histopathological significance of infection in the HGM patches. From 63 patients with HGM patches at the upper esophagus, 48 patients were found to have concurrent adequate specimen from the stomach for modified Steiner's stain. In 22 patients (45.8%), pair sections from HGM and stomach were negative for HP. Of 26 patients (54.1%) HP-positive on sections from the antrum and/or body (both in 21 cases) nine patients (18.7%) demonstrated HP in the HGM patches. Whereas focal acute inflammatory changes on the HandE section of HGM was present in six patients, HP was detected in HGM only in one. Chronic inflammatory cell infiltration was detected in all nine HP-positive HGM patches and in 37 of 39 HP-negative patches. A mixed acute and chronic inflammatory cell infiltration was found in five of these 37 patients. Our data demonstrate that HP infection of HGM patches at the upper esophagus is part of the HP gastritis and an independent colonization of HGM patches without gastric infection does not occur. No correlation was found between the presence of acute and chronic inflammatory changes in HandE-stained section and positivity of HP in modified Steiner's section of HGM.

幽門螺桿菌感染在世界範圍內普遍存在，超過50%的世界人口都曾被感染。幽門螺桿菌與胃炎，胃潰瘍，胃癌和其他胃內疾病的發生密切相關。盡管目前已有多種有效除菌的抗生素，但耐藥菌的出現仍然不可忽視。防止幽門螺桿菌感染能有效的減緩疾病進程及其相關疾病引發的死亡率。因此，新藥物或者新的藥物劑型的研發十分重要。 / Cathelicidin是一種宿主免疫防禦系統用於抵抗不同種類病原微生物感染的生物肽。然而，其在幽門螺桿菌感染引發的炎癥中的作用仍未被揭示。本研究旨在發現Cathelicidin在幽門螺桿菌體內及體外感染中的可能抗菌作用及其機制。為了研究不同劑量Cathelicidin對幽門螺桿菌的直接抗菌作用，我們主要觀察了細菌生長，生物膜形成及細菌形態的改變。實驗結果表明，Cathelicidin可有效的抑制幽門螺桿菌的生長，破壞其生物膜形成，及在細菌胞膜形成孔狀結構，以改變其正常的超微形態。 / 在宿主抵禦幽門螺桿菌感染的機制中，自噬不僅具有抗菌活性，同時在清除胃上皮細胞內病原體的方面發揮著重要作用。然而，幽門螺桿菌則可能得益於自噬通路，並掌控自噬這一工具，進而幫助其自身的存活及感染。 / 研究發現，維生素D於體內的活性形式1,25 - 二羥維生素D3（1,25D3）可促進Cathelicidin的合成及激活自噬通路，從而發揮自身免疫來殺死在胃上皮細胞內定植的幽門螺桿菌。此外，通過RNAi沈默技術，與對照基因沈默的細胞相比，LL-37在人胃上皮細胞（HEF-145）中表達被抑制後，細胞內幽門螺桿菌的存活數量顯著上升。同樣的結果也被發現於動物模型中，在急性及慢性幽門螺桿菌感染的小鼠模型中，CRAMP基因敲除小鼠胃內的幽門螺桿菌數量比野生型小鼠胃內更多。 / 為了進一步研究Cathelicidin是否具有潛在的治療幽門螺桿菌感染的作用，本研究采用生物工程的方法將CRAMP轉入乳酸球菌中，再將這種分泌CRAMP型及對照組乳酸球菌餵給被幽門螺桿菌感染的小鼠。預防性和治療性的研究結果表明，這種能夠分泌CRAMP的益生菌可在胃黏膜表面存活和定植。更多的幽門螺桿菌能夠定植在CRAMP基因敲除小鼠的胃內，同時其胃內的促炎癥因子，IL-6，IL-1β及ICAM表達也高於野生型小鼠。此外，幽門螺桿菌感染上調了野生型小鼠胃上皮型來源的CRAMP表達，這一結果可部分解釋為什麽在野生型小鼠胃內只有少量幽門螺桿菌及輕度炎癥反應的原因。 / 重要的是，預防性及治療性的實驗顯著的提高了兩種小鼠胃黏膜中抗菌肽的水平，並降低了幽門螺桿菌感染及促炎癥因子mRNA的表達。值得注意的是，預防性的給藥還促進了胃粘液層的合成及防止表皮細胞雕亡，從而加強胃黏膜屏障的保護作用。 / 總結而言，本研究結果揭示Cathelicidin作為一種天然抗生素，在清除幽門螺桿菌及治療其引發的慢性胃炎中發揮重要的作用。分泌Cathelicidin型食用益生菌和幫助Cathelicidin內源性表達的1,25D3則有望發展成為新型的生物制劑用於防治動物和人體幽門螺桿菌感染及其引發的相關性胃炎。 / Helicobacter pylori (H. pylori) infection is one of the most prevalent infectious diseases, affecting more than 50% of the world’s population and responsible for gastritis, peptic ulcer, gastric cancer and other stomach disorders. / Although there are antibiotics which are effective to eradicate the bacteria, the worldwide appearance of drug resistance to H. pylori is common. It is therefore needed to search for new therapeutic agents or establish a new form of drug delivery system to prevent H. pylori infection at the early stage in order to reduce the disease progression and its associated morbidities. / Cathelicidin, a host defense antibacterial peptide in humans can eradicate different kinds of microbial infection. However, its roles in H. pylori infection and inflammation remain unexplored. This study sought to elucidate the possible actions and mechanisms for cathelicidin to protect against H. pylori infection and its associated inflammation both in vitro and in vivo. / To examine the direct antimicrobial action of cathelicidin, H. pylori survival, biofilm formation and morphology change were determined after exposure to different doses of cathelicidin in vitro. Results showed that exogenous cathelicidin could affect H. pylori growth, destroy bacteria biofilm and cause pore formation in H. pylori membranes. With respect to the host defense against H. pylori infection, autophagy plays a crucial role in antimicrobial activity, and contributes to clearance of intracellular pathogens in gastric cells. In this regard, H. pylori might benefit from autophagy pathway, and subvert the autophagy machinery in favor of its survival and infectious process. / The active form of vitamin D3, 1, 25-dihydroxyvitamin D3 (1, 25D3) activated LL-37, a human cathelicidin antimicrobial peptide and produced autophagy, which could contribute to host immune responses against intracellular survival of H. pylori in gastric cells. Additionally, we transfected gastric epithelial cells (HFE-145) with siRNA specific for LL-37 (siLL-37) to knockdown the expression of LL-37 in HFE-145 cells, which markedly increased the number of intracellular H. pylori when compared to cells transfected with a scrambled control siRNA (Csi). Consistent with these findings, cathelicidin knockout (Cnlp⁻/⁻) mice exhibited stronger H. pylori colonization in stomachs with acute and chronic H. pylori infection when compared to the stomachs in cathelicidin wild-type (Cnlp⁺/⁺) mice. / To further examine whether cathelicidin could be used as a therapeutic agent for H. pylori infection, we replenished exogenous CRAMP in H. pylori infected Cnlp⁺/⁺ and Cnlp⁻/⁻ mice with a bioengineered CRAMP-secreting strain of Lactococcus lactis (L. lactis) in a cost-effective manner. To this end, Cnlp⁺/⁺and Cnlp⁻/⁻ mice were pre-treated or post-treated with the control plasmid-encoded L. lactis or CRAMP-encoded L. lactis in H. pylori infected mice. They were then assessed for H. pylori infection and inflammatory responses in stomachs. Results showed that the probiotic L. lactis could survive in the gastric mucosa. In the absence of CRAMP, Cnlp⁻/⁻ mice exhibited more H. pylori harboring in the stomach together with marked expressions of IL-6, IL-1β and ICAM in the gastric mucosa when compared to wild type mice. Furthermore, in Cnlp⁺/⁺ mice, H. pylori infection stimulated gastric epithelium-derived CRAMP production but not in the Cnlp⁻/⁻ mice. These findings could partially explain why there were less bacterial infection and inflammatory responses in the wild type animals. Importantly, pre-treatment and post-treatment with CRAMP-encoded L. lactis significantly increased mucosal CRAMP level in both types of animals and reduced H. pylori infection and also pro-inflammatory cytokines mRNA expressions in these stomachs. It was noteworthy that delivering CRAMP intragastrically before H. pylori challenge strengthened the mucosal barrier by stimulating mucus layer synthesis and preventing epithelial cell apoptosis. / Collectively, these findings indicate that cathelicidin plays a significant role as a potential natural antibiotic for H. pylori clearance and a therapeutic agent for chronic gastritis. The increase of cathelicidin expression in the gastric mucosa either by the food-grade probiotic encoded with cathelicidin or the active form of vitamin D, could be promising biological preparations for the treatment of H. pylori infection and its associated gastritis in animals and perhaps also in humans. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Zhang, Lin. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 144-170). / Abstract also in Chinese. / ABSTRACT --- p.I / 中文摘要 --- p.V / DECLARATION --- p.VII / ACKNOWLEDGEMENTS --- p.VIII / PUBLICATIONS --- p.XIV / LIST OF ILLUSTRATIONS --- p.XIX / INTRODUCTION --- p.1 / Chapter 1.1 --- Helicobacter pylori --- p.1 / Chapter 1.1.1 --- Overview --- p.1 / Chapter 1.1.2 --- Epidemiology of H. pylori infection --- p.2 / Chapter 1.1.3 --- Diagnosis and treatment strategies for H. pylori-induced diseases --- p.2 / Chapter 1.1.4 --- Bacteria autophagy: restriction or persistence of infection? --- p.3 / Chapter 1.1.5 --- Virulence factors of H. pylori related to autophagy --- p.8 / Chapter 1.1.6 --- Future research directions concerning H. pylori and autophagy --- p.11 / Chapter 1.2 --- Cathelicidins --- p.11 / Chapter 1.2.1 --- Overview --- p.11 / Chapter 1.2.2 --- Cathelicidin and its antimicrobial action and possible mechanisms --- p.12 / Chapter 1.2.3 --- Mouse cathelicidin deficient model --- p.16 / Chapter 1.2.4 --- Multiple receptors enable diversified activities of cathelicidins --- p.17 / Chapter 1.2.5 --- Endogenous cathelicidin induction --- p.23 / Chapter 1.2.5 --- New uses for old drugs --- p.26 / METHODS --- p.29 / Chapter 2.1 --- General Materials --- p.29 / Chapter 2.1.1 --- Chemicals and reagents --- p.29 / Chapter 2.1.2 --- Antibodies --- p.33 / Chapter 2.1.3 --- Commercial Kits --- p.34 / Chapter 2.1.4 --- Bacteria and culture conditions --- p.35 / Chapter 2.1.5 --- Animals --- p.36 / Chapter 2.1.6 --- Cell Line --- p.36 / Chapter 2.2 --- Experimental Designs --- p.37 / Chapter 2.2.1 --- In vitro studies --- p.37 / Chapter 2.2.2 --- In vivo studies --- p.44 / Chapter 2.3 --- Statistical analysis --- p.52 / RESULTS AND DISCUSSION --- p.53 / Chapter 3.1 --- Antimicrobial activity of cathelicidin on H. pylori in vitro --- p.53 / Chapter 3.2 --- Anti-biofilm formation activity of cathelicidin on H. pylori in vitro --- p.58 / Chapter 3.3 --- Manipulation of autophagy by H. pylori for their survival --- p.62 / Chapter 3.3.1 --- H. pylori stimulated dysfunctional autophagy --- p.62 / Chapter 3.3.2 --- H. pylori compromised the autophagic flux in cells and thereby promoting self-multiplication --- p.68 / Chapter 3.3.3 --- Autophagy is a host defense process in controlling intracellular survival of H. pylori --- p.71 / Chapter 3.4 --- Vitamin D3 inhibited H. pylori infection through the induction of autophagy --- p.76 / Chapter 3.4.1 --- 1,25D3 triggered the formation of autophagosomes and autophagolysosomes in gastric epithelial cells --- p.76 / Chapter 3.4.2 --- 1,25D3 treatment inhibited intracellular H. pylori survival through induction of autophagy by cathelicidin --- p.79 / Chapter 3.5 --- Discussion --- p.86 / Chapter 3.6 --- Elucidation of the role of endogenous and exogenous cathelicidin in H. pylori colonization and the associated gastritis --- p.94 / Chapter 3.6.1 --- H. pylori SS1 colonized in Cnlp⁺/⁺ and Cnlp⁻/⁻ mouse gastric epithelium --- p.94 / Chapter 3.6.2 --- Endogenous cathelicidin protects against H. pylori SS1 colonization in vitro and in vivo --- p.96 / Chapter 3.6.3 --- Endogenous cathelicidin protects against drug-resistant H. pylori 10783 colonization --- p.100 / Chapter 3.6.4 --- The bioengineered L. lactis encoded with CRAMP could localize in mouse stomachs and express CRAMP mRNA --- p.104 / Chapter 3.6.5 --- Effects of CRAMP secreting bioengineered L. lactis on H. pylori growth in vitro --- p.106 / Chapter 3.6.6 --- Post-treatment of CRAMP-encoded L.lactis on H. pylori colonization and its associated gastritis --- p.108 / Chapter 3.6.7 --- Pre-treatment of CRAMP-encoded L.lactis on H. pylori colonization and its associated gastritis --- p.118 / Chapter 3.7 --- Discussion --- p.129 / SUMMARY AND FUTURE PERSPECTIVES --- p.140 / REFERENCES --- p.144

預激活綜合體的形成對於脲酶的成熟是必需的。所以作為預激活綜合體一部份，UreF/UreG/UreG綜合體的形成也是脲酶成熟的關鍵之一。從幽門螺桿菌UreF/UreH的晶體結構顯示出是一個由異源二聚體形成的二聚體，這UreF/UreH二聚體和幽門螺桿菌的脲酶都有擁有個獨特的二重對稱性。而UreF/UreH二聚體的長度和幽門螺桿菌脲酶獨特的二次軸上那兩個催化中心的距離很接近。這讓我們聯想到UreF/UreH二聚體的二聚化是否與脲酶的活性有關。所以跟據UreF/UreH的晶體結構，計計了三個証實可以破壞UreF二聚化的突變體(F33D/Q37A, R179A/Y183D and F33D/Q37A/R179A/Y183D)。而這些突變體與UreH的結合體都保留了和脲酶結舍的能力卻失去了和UreG結合的能力，所以都不可以結合成完整的預激活綜合體來熟化脲酶。為了UreF/UreH二聚面的虛擬篩選，AutoDock Vina和Dock6.5,這兩個篩選程式用了DUD去做了一些基準。而基於一個百分比的富集值和首個已知配體的百分比值， Dock6.5比AutoDock Vina優勝，所以會用Dock6.5來篩選可以綁定UreF的二聚分介面的分子。最後，分析Dock6.5前1排名的分子，這些分子可以跟據它們和UreF殘基的接觸分類。 / The formation of the pre-activation complex is essential for the urease maturation. Being part of the pre-activation complex, the formation of theUreF/UreG/UreH complex is crucial for the formation of the complete preactivation complex. The crystal structures of Helicobacter pylor iUreF/UreH had been determined showing a dimer of heterodimer formation. The structure of UreF/UreH complex and H. pylori urease shared a unique two-fold symmetry. Moreover, the length of the UreF/UreH complex is similar to the distance of the two catalytic centres on the two-fold symmetry axis. This brought to the question: whether the dimerization of the UreF in the UreF/UreH complex has an effect on the H. pylori urease activity. According to the UreF/UreH crystal structure, three UreF mutants (F33D/Q37A, R179A/Y183D and F33D/Q37A/R179A/ Y183D) were designed and all were able to break the dimerization of UreF. These mutants were not able to interact with UreG, hence the complete pre-activation complex could not be formed and the maturation of urease was inhibited. Working towards to the virtual screening of the UreF/UreH complex dimerization surface, two docking programs, AutoDock Vina and Dock 6.5 were benchmarked using the DUD set. Dock 6.5 out performed AutoDock Vina by comparing the EF1 (Enrichment Factor of the top1% ranked ligands) and the percentage ranking of the first true hit. Using Dock 6.5, UreF residues that make the most contacts with the ligands had been identified using the top 1% of the ranked ligands. / Detailed summary in vernacular field only. / Yuen, Man Hon Nicholas. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 72-74). / Abstracts also in Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / 論文摘要 --- p.iii / Table of Content --- p.iv / Figures List --- p.vi / Tables List --- p.vi / Chapter Chapter 1 --- introduction --- p.1 / Chapter Introduction --- p.1 / Chapter 1.1 --- What is urease? --- p.1 / Chapter 1.2 --- Role of urease in H. pylori --- p.3 / Chapter 1.3 --- Structure of urease --- p.4 / Chapter 1.4 --- The active site of urease --- p.6 / Chapter 1.5 --- Accessory proteins are needed for urease maturation --- p.8 / Chapter 1.6 --- Crystal structure of H. pylori UreF/UreH complex --- p.12 / Chapter 1.7 --- Objective --- p.14 / Chapter Chapter 2: --- Material and Methods --- p.15 / Chapter 2.1 --- General Techniques --- p.15 / Chapter 2.1.1 --- Preparation and transformation of Escherichia coli competent cells --- p.15 / Chapter 2.1.2 --- Agarose gel electrophoresis of DNA --- p.16 / Chapter 2.1.3 --- Polymerase Chain reaction, PCR --- p.17 / Chapter 2.1.3.1 --- Basic protocol --- p.17 / Chapter 2.1.3.2 --- Generation of HisGST-UreF mutants --- p.18 / Chapter 2.1.4 --- Restriction digestion of DNA --- p.18 / Chapter 2.1.5 --- SDS-polyacryamide gel electrophoresis, SDS-PAGE --- p.19 / Chapter 2.1.6 --- Staining of polyacrylamide gel --- p.20 / Chapter 2.2 --- Expression and Purification of Recombinant Proteins --- p.21 / Chapter 2.2.1 --- General bacterial culturing, harvesting and lysis procedures --- p.21 / Chapter 2.2.2 --- Purification of wild type HisGST-UreF and mutants with UreH --- p.22 / Chapter 2.2.3 --- Purification of Urease (UreAC) --- p.23 / Chapter 2.2.4 --- Purification of His-SUMO-UreG --- p.24 / Chapter 2.3 --- Static light scattering, SLS --- p.25 / Chapter 2.4 --- In vitor Urease Activity --- p.26 / Chapter 2.5 --- In vitor Urease Activity --- p.27 / Chapter 2.6 --- Virtual Screening --- p.28 / Chapter 2.6.1 --- Docking with Dock 6.5 --- p.28 / Chapter 2.6.2 --- Docking with AutoDock Vina --- p.29 / Chapter 2.6.3 --- Enrichment factor calculation --- p.29 / Chapter 2.7 --- Reagents and Buffers --- p.30 / Chapter 2.7.1 --- Buffers for competent cells preparation --- p.30 / Chapter 2.7.2 --- Nucleic acid electrophoresis buffers --- p.30 / Chapter 2.7.3 --- Media fr bacterial culture --- p.30 / Chapter 2.7.4 --- Reagents for SDS-PAGE --- p.31 / Chapter 2.7.5 --- Reagents and Buffers for in vitro Urease Activity Assay --- p.32 / Chapter 2.7.6 --- Reagents and Buffers for in vitro Urease Activity Assay --- p.32 / Chapter Chapter 3 --- Dimerization of UreF is Essential for Urease Maturation --- p.33 / Chapter 3.1 --- Introduction --- p.33 / Chapter 3.2 --- Results --- p.34 / Chapter 3.2.1 --- Mutant design --- p.34 / Chapter 3.2.2 --- When expressed alone, the UreF mutants were found in the inclusion Body --- p.36 / Chapter 3.2.3 --- Co-expressing UreFmutants with UreH would solublize UreF mutants and the interactions between UreF mutants and UreH were retained --- p.36 / Chapter 3.2.4 --- UreF oligomerizationstate determination by size exclusion chromatography / static light scattering (SEC/LS) --- p.39 / Chapter 3.2.5 --- UreF dimerization is necessary for the interaction between the UreF/UreH complex and UreG --- p.41 / Chapter 3.2.6 --- UreF dimerization is not involved in the interaction between the UreF/UreH complex and Urease(UreA/UreC) --- p.43 / Chapter 3.2.7 --- UreF dimerization is essential for in vitro Urase Maturation --- p.45 / Chapter 3.2.8 --- UreF dimerization is essential for in vivo Urase Maturation --- p.47 / Chapter Chapter 4 --- Benchmarking Virtual Screening Performance of AUTODOCK VINA and DOCK 6.5 - Towards Virtual Screening of Inhibitors for Uref/UreH Complex Dimerization --- p.53 / Chapter 4.1 --- Introduction --- p.53 / Chapter 4.2 --- Benchmarking AutoDock Vina and Dock 6.5 --- p.54 / Chapter 4.2.1 --- Description of the Directory of Useful Decoys (DUD) set --- p.54 / Chapter 4.2.2 --- Benchmarking AutoDock Vina and Dock 6.5 shoewing Dock 6.5 has a better overall EF1 --- p.57 / Chapter 4.2.3 --- Dock 6.5 has a higher first hit percentile --- p.60 / Chapter 4.2.4 --- Analysis of the binding site for the top 1% ranked ligand for UreF Dimerization surface --- p.63 / Chapter 4.3 --- Discussion --- p.68 / Chapter Chapter 5 --- Conclusion --- p.71 / References --- p.72

La cancérogenèse gastrique est un processus d’origine multifactorielle, incluant des facteurs génétiques de l’hôte, mais aussi d’origine bactérienne et de l’environnent. Les populations humaines peuvent être exposées directement ou indirectement à des composés toxiques/génotoxiques présents dans les plantes, comme la fougère Pteridium aquilinum. Cette plante comprend une toxine, le ptaquiloside associée à des maladies graves et le développement de cancer chez les animaux. Des études épidémiologiques ont démontré une association entre l'exposition à ces fougères et l’incidence du cancer gastrique dans les populations humaines. Cependant, un autre facteur de risque majeur dans le développement du cancer gastrique est la bactérie Helicobacter pylori qui colonise l'estomac humain et induit une réponse génotoxique. Cette étude vise à caractériser l'implication biologique et moléculaire de Pteridium aquilinum et de sa toxine le ptaquiloside dans le processus de cancérogenèse gastrique et d'explorer un effet de synergie potentiel avec l'infection par H. pylori.Nous avons montré que le traitement avec des extraits de Pteridium aquilinum et le ptaquiloside diminue la viabilité cellulaire et favorise l'apoptose des cellules épithéliales gastriques. L'induction de cassures de l'ADN a été observée, exacerbée en présence de l’infection par H. pylori. Dans les cellules traitées, la protéine p53 est induite et associée à l'activation de la voie de signalisation ATR-Chk1. Cette augmentation de p53 est aussi détectée en présence des souches virulentes de H. pylori. L’induction de lésions à l’ADN par le ptaquiloside est en accord avec la dérégulation observée de l’expression d’un certain nombre de gènes impliqués dans la régulation du cycle cellulaire et la réparation de l'ADN. De plus, des souris exposées à Pteridium aquilinum, montrent des modifications histomorphologiques de la muqueuse gastrique ainsi qu’une augmentation de la prolifération cellulaire et l'induction de mutations dans le gène p53 après 7 semaines de traitement. Toutefois, bien qu’une exacerbation de la prolifération cellulaire et des lésions histologiques soient induites par un traitement chronique en association avec l'infection à H. pylori pendant 12 mois, aucune différence significative dans l'expression du gène p53 a été mise en évidence. Cependant, dans ces conditions, une modification du schéma glycophenotypique a été induite dans la muqueuse gastrique des souris. Différentes glycosyltransférases impliquées dans la biosynthèse des antigènes simples de mucines et terminaux antigènes Lewis ont été différentiellement exprimées chez les souris non-infectées et infectées, respectivement. Ces résultats sont également validés par une augmentation de l’expression de Sialyl-LewisX.De plus, des modifications des glycosyltransférases impliquées dans les étapes initiales de O-glycosylation ont été observées. Le ppGalNAcT6 a présenté une expression altérée dans un carcinome gastrique, associée à la présence de l'invasion veineuse.En conclusion, nos données confirment l’activité génotoxique de Pteridium aquilinum et du ptaquiloside sur les cellules gastriques, supportant leur rôle fondamental dans la promotion de la cancérogenèse gastrique. Cette activité est exacerbée en présence de l’infection par H. pylori, soulignant l'importance de l'interaction de ces deux facteurs de risque dans ce processus. / The multifactorial gastric carcinogenesis process encompasses host genetic susceptibility, bacterial and environmental factors. Humans can directly consume or be indirectly exposed to toxic compounds present in plants, such as the bracken fern Pteridium aquilinum. This plant has a carcinogenic toxin, ptaquiloside, and is known to cause severe health problems in animals, including cancer. Epidemiological evidence also demonstrated an association between bracken exposure and gastric cancer development in Humans. Additionally, another major etiological agent is Helicobacter pylori, a bacterium that colonizes the stomach inducing a genotoxic response in gastric cells. This study aimed to characterize the biological and molecular involvement of Pteridium aquilinum and its ptaquiloside toxin in the gastric carcinogenesis process and to evaluate the potential synergistic effect of H. pylori infection.We observed that treatment with Pteridium aquilinum extracts and ptaquiloside toxin decreased cell viability and promoted cell apoptosis in gastric epithelial cells. A genotoxic effect with induction of DNA strand breaks was noted and it was exacerbated in the presence of H. pylori infection. We further demonstrated that in treated cells a p53 accumulation occurs, controlled by the activation of the ATR-Chk1 DNA damage signalling pathway. An increased level of p53 was also detected in the presence of a H. pylori virulent strain. The contribution of ptaquiloside to this genotoxic activity was supported by the deregulation of other genes involved in DNA cell cycle regulation and DNA repair. In addition, using a mouse model exposed to Pteridium aquilinum, we detected histomorphological alterations with increased cell proliferation and induction of frameshift events in the p53 gene. However, a concomitant chronic treatment with Pteridium aquilinum and H. pylori infection did not produce significant differences in p53 gene expression.Moreover, an altered glycophenotypic pattern was induced in the gastric mucosa of mice upon Pteridium aquilinum treatment in the presence of H. pylori infection. Several glycosyltransferases involved in the biosynthesis of simple mucin-type carbohydrate antigens and terminal Lewis antigens were differently expressed in the absence and presence of H. pylori, respectively. These results were also validated by an increased expression of Sialyl-LewisX.Further alterations in glycosyltransferases involved in the initial steps of O-glycosylation were observed. The ppGalNAcT6 was shown to have a heterogeneous expression in human gastric carcinoma, associated with the presence of venous invasion.Overall, our data supports the notion that cell exposure to the genotoxic and carcinogenic Pteridium aquilinum and ptaquiloside has a fundamental role in the promotion of gastric carcinogenesis. The synergistic environment associated to H. pylori infection underlines the importance of risk factor interplay in this process. / A carcinogénese gástrica é um processo multifatorial que engloba fatores genéticos, bacterianos e ambientais. O Homem pode consumir diretamente ou ser exposto de forma indireta a compostos tóxicos presentes em plantas, como é o caso do feto vulgar Pteridium aquilinum. Esta planta tem uma toxina carcinogénica, o ptaquilosídeo, sendo conhecida a sua capacidade natural para induzir lesões neoplásicas em animais. Estudos epidemiológicos também demonstraram a existência de uma associação entre a exposição ao feto e o desenvolvimento de cancro gástrico em humanos. Outro fator etiológico importante é a Helicobacter pylori, uma bactéria que coloniza o estômago, induzindo nas células gástricas uma resposta genotóxica. Este estudo tem por objetivos caracterizar o envolvimento biológico e molecular do Pteridium aquilinum e da sua toxina, ptaquilosídeo, no processo de carcinogénese gástrica e avaliar o potencial efeito sinergístico da infeção por H. pylori.Observámos em células epiteliais gástricas que o tratamento com extratos de Pteridium aquilinum e com a toxina ptaquilosídeo, diminui a viabilidade celular e promove a apoptose. Foi demonstrado um efeito genotóxico com indução de quebras na cadeia de ADN, exacerbado pela presença da infeção por H. pylori. Demonstrámos ainda que, em células tratadas, ocorria uma acumulação de p53, controlada pela ativação da via de sinalização ATR-Chk1. Um aumento nos níveis de p53 foi igualmente detetado na presença de estirpes virulentas de H. pylori. A contribuição do ptaquilosídeo para esta atividade genotóxica foi também apoiada pela desregulação de outros genes envolvidos na regulação do ciclo celular e na reparação do ADN. Adicionalmente, usando um modelo de ratinho exposto ao Pteridium aquilinum, foram detetadas alterações histomorfológicas, bem como um aumento da proliferação celular e indução de mutações no gene p53. Contudo, um tratamento crónico com Pteridium aquilinum e infeção concomitante por H. pylori não produziu diferenças significativas na expressão do gene p53.Um padrão glicofenotípico alterado foi também observado na mucosa gástrica de ratinhos tratados com Pteridium aquilinum na presença de infeção por H. pylori. Várias glicosiltransferases envolvidas na biossíntese de antigénios simples das mucinas e antigénios terminais do tipo Lewis apresentaram uma expressão alterada, respetivamente, na ausência ou presença de H. pylori. Estes resultados foram também validados através de um aumento da expressão de Sialil-LewisX.Foram ainda observadas alterações em glicosiltransferases que estão envolvidas nas etapas iniciais de O-glicosilação. A ppGalNAcT6 apresentou uma expressão alterada em carcinomas gástricos, estando associada à presença de invasão venosa.No geral, estes dados suportam a evidência de que a exposição das células aos genotóxicos e carcinogénicos Pteridium aquilinum e ptaquilosídeo, tem um papel fundamental na promoção da carcinogénese gástrica. O ambiente sinergístico associado à infeção com H. pylori salienta a importância da interação entre os fatores de risco que dão origem a este processo.